Background
Nutrition is key to life. “In fact people are pack of nutrients and they need all the nutrition since the formation of embryo to become a mature human. They need nutrition to keep on restoring depleted nutrition throughout the life.” This makes maternal, childhood, adult nutrition equally important throughout the life course of human.
How does Nutrition affect the Health?
If you don’t get adequate and essential nutrients, physical and mental growth will be delayed through various mechanisms, causes many diseases and even leads to death. The foremost mechanism is direct nutritional deficiency diseases such as deficiency of Vitamin A causes night blindness; imbalance of protein and carbohydrate results in PEM malnutrition, obesity; Iodine deficiency causes mental retardation, goiter. There are number of disease conditions that are directly related to the nutrition deficiencies. Such diseases are also responsible for other chronic disease such as cardiovascular diseases, diabetes.
Figure: Factors affecting Nutrition and its impact on health
Lack of nutrition also reduces immunity thereby making our body susceptible to many opportunistic infectious microorganisms. As for example, in a healthy people, tuberculosis could be in dormant phase but once the immunity or defense system of our body is disturbed, TB pathogen can become active and manifest TB disease. Viral infections are especially immunity relative and immunocompromised people suffer bouts of seasonal influenza or diarrheal diseases compared to people with strong immunity.
Anthropometric measures to measure the nutritional status of children
Anthropometry is the study of measurement of body parts. Nutritional status can be measured by various indicators such as mid arm circumference, BMI, height for age, weight for height, weight for age etc. However, the last three aforementioned indicators are used frequently.
Height for age: children should have comparable height for their age just like other children in their age group. If their height is below two standard deviations of that age group, then it is considered less height for age showing inadequate nutritional status. Having short gesture for age is also known as stunting. stunting is usually taken as sign of long term, chronic nutritional deprivation
Weight for height : Having short gesture or height for weight is also known as wasting. wasted children have short gesture for weight.If their weight for height is below two standard deviations of that age group, then it is considered less weight for height showing inadequate nutritional status. Low weight for height is an indicator of acute undernutrition
Weight for age : Similarly, this is one of the commonest and easiest way to measure the nutritional status of the children. children should have comparable weight for their age just like other children in their age group. If their weight is below two standard deviations of that age group, then it is considered low weight for age showing inadequate nutritional status. This combines information about linear growth retardation and weight for height
Indicators in NDHS Nepal Demographic and Health Survey 2016
According to NDHS 2016, 36 % of the children are stunted or have short gesture for that age group, 10% of the children are wasted or have lower weight for height and 27% under five children are underweight or have weight low for their age. These show Progress from the early years.
What are the reasons of Nutritional deficiency in Nepal?
I would like to describe the causes of nutritional deficiencies based on socio-ecological model.
- Policy: Certainly, Nepal is a developing country and significant fraction of people live under the poverty and very far from the light of development and education. The policy helps to shape the investment in different section of the programmes and population.
- Society, organization and culture: The culture, tradition and some taboos prevalent in the society, and organization equally affects the nutritional level of the population. Certain tradition like early weaning of female child, taboos prohibiting some foods during pregnancies, gender discrepancy in nutrition etc affect the nutrition of the children.
- Family level factors: socioeconomic status of the family, trade off of investment in other things vs nutrition also affects the family's importance in nutrition. This also depends upon the over all understanding of importance of nutrition.
- Individual level factors: Education of parents, other family members, occupation, knowledge about the nutrients, balanced diet and preparation, handling of the foods also affect the nutrition of the children
- International support: International support has tremendous influence over the policy and programmes and current programs like SUAAHARA project is funded by USAID. Many UNITED NATIONS organization have focussed in improving child nutrition in Nepal and all over the world affected by malnutrition.
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